Malaria Caution for Travelers

Malaria cases in the U.S. reached a 40-year-high in 2011, the Centers for Disease Control and Prevention (CDC) reported last week. More than 1,900 cases were diagnosed—a 14 percent increase from the previous year. (Figures for 2012 are not yet available.) The number of severe cases of malaria also rose significantly in 2011, and five people died from the illness or related complications.

The surveillance report, published in the CDC’s Morbidity and Mortality Weekly Report, should serve as a warning to travelers, since almost all cases were contracted overseas. The single largest number of cases came from India, with 223; Nigeria followed, with 213 cases. Overall, two-thirds of the cases were in people who had been in West Africa.

Americans planning trips to countries where malaria is endemic should be vigilant about taking preventive measures. Anti-malarial drugs—along with insect repellent, bed nets and appropriate clothing—offer extensive, if not foolproof, protection against infections. The CDC study found that most of those who contracted malaria in 2011 were not taking anti-malarial drugs, or were taking them inconsistently.

Physicians, too, should be alert to the possibility of malaria and ask patients about any international travel plans. Since the disease was eradicated in the U.S. in the years after WWII, most health care personnel have never seen a case and might not consider the diagnosis if a patient presents with malaria symptoms.

Malaria is one of the world’s devastating diseases, with an estimated 219 million cases and 660,000 deaths every year. Caused by a parasite transmitted to humans by certain mosquito species, malaria induces fever, headaches, chills, nausea, diarrhea and other flu-like symptoms. Severe cases, if untreated, can lead to kidney failure, seizures, respiratory distress and blood abnormalities. Despite years of effort, no vaccines have proven successful, although some promising new candidates are under investigation.